Bone foundation guide system and method

ABSTRACT

A bone foundation guide system has a bone foundation guide including a body that is contoured to reversibly affix to a bone segment of a dental implant surgical site. The body is further contoured to guide the cutting of a portion of the bone segment from a dental implant surgical site and alternatively support a dental implant surgical guide. The body is further contoured to support a bone foundation guide prosthesis as an alternative to the dental implant surgical guide. The bone foundation guide prosthesis combines with the body to accommodate the bone segment portion as placed through the body prior to the bone segment portion being removed from the dental implant site through the use of the body.

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT

Not Applicable

REFERENCE TO A “MICROFICHE APPENDIX”

Not Applicable.

FIELD OF THE INVENTION

The present invention generally relates to dental implant and surgicalguides. More particularly to those bone modification guides that supporta dental implant surgical guide.

BACKGROUND

As a person ages, they generally incur tooth and bone loss requiringprosthetic replacement as provided by the dental profession. One of themore important aspects of this replacement procedure is the need tosolidly anchor within the available bone structure those implants usedto secure individual (replacement artificial tooth) or collective (e.g.,denture) dental prosthetic. When teeth lose bone around their roots, thebone (e.g., mandibular strut or the maxillary strut) may become uneven(either thinned out or too bulky) in various places in the respectivedental strut. This bone condition may make the dental restorativeprocess in that particular area more difficult than when such bone losshas not occurred. It could be thought as building a house whosefoundation on an unleveled or uneven ground.

In order for the dental prosthetic (or restoration) to be properlyfitted to the patient in a substantially esthetically and functionallyacceptable position, the dental health care professional (e.g. dentalsurgeon) may first have to alter the bone of the dental surgical site(especially in those situations where the dental prosthetic isredressing significant tooth loss). This corrective process could startby making one or more incisions in gum area that otherwise designatesthe dental surgical or restoration site. These incisions substantiallyallow the gum tissue to be peeled back to expose the bone at the dentalsurgical site. The dental surgeon, in order to generally make dentalsurgical site/dental arch symmetrical in all relevant dimensions for thedental restoration (e.g., removable denture) or implant sites (e.g.fixed prosthetics) may then apply one or more cutting tools to generallyreduce or remove unwanted high points or thickened places on the exposedbone structure. In other instances, the dental surgeon may add bonematerial to the exposed bone structure to further fill out the arch'sprofile or otherwise strengthen its structure.

During this process, the dental surgeon could bring the top portion ofthe alveolar ridge (e.g., one of the two jaw ridges either on the roofof the mouth or the bottom of the mouth that contain the sockets oralveoli of the teeth) to the correct surgical dimensions (“levelingout”) by utilizing a bone foundation guide generally placed upon andsecured to the bone structure to substantially guide thecutting/augmenting of the exposed bone. The bone foundation guide solvesthe problem of “estimating” the vertical height and width of the bone atthe “coronal” level by guiding the surgeon's operation of the cuttingtools and/or augmentation of the bone. This allows subsequent andaccurate placement of the dental implants and respective prosthetics atthe proper patient-specific vertical and horizontal levels. This boneadjustment process may also provide for the creation of the properinter-occlusal room (e.g., the space that exists between the opposingteeth and the open tissue (e.g., that will receive the dentalprosthetic) to generally insure that proper jaw operation and alignment,smile line and phonetics occur when the final dental prosthetic isfinally located within the patient's mouth.

After the exposed bone has been properly been prepared (e.g., reduced oraugmented), the bone foundation guide may be removed. A dental implantsurgical guide may be subsequently fitted and attached in its place atthe remodeled bone of dental surgical site. The dental implant surgicalguide may be used to guide the operation of implant accessories neededto prepare the dental surgical site to receive the dental implants. Thedental implant surgical guide may then be used to suitably locate thedental implants into the prepared bone structure. After the dentalimplants are properly located, the dental implant surgical guide may beremoved and healing abutments (if required) may be fitted to the dentalimplants to create a space in the reattached gum proximate to the dentalimplant(s) that receives a portion (e.g., the base) of prosthetic orprosthesis (e.g., artificial tooth). Once the healing abutments areattached, the gum tissue may sutured back up and around the dentalimplant-healing abutment combination.

As needed, a full upper or full lower denture/tooth may be fitted to theimplants either at the close of the dental surgery or later afterhealing of the tissues/osseo-integration of bone to implant(s) hasoccurred. Once the healing/osseo-integration has finalized, the dentalsurgeon could remove the healing abutments to open up the spaceproximate to the implants that receives the base of the prosthetic toplace and affix the dental prosthetic securely to the implant(s).

The bone foundation guide and the implant dental surgical guide for theimplants are generally considered separate instruments that aregenerally designed, manufactured and used independently of one anotherother. The design and creation of these guides can be now beaccomplished through digital dentistry (e.g., pre-surgical digitalmethods and associated apparatuses to obtain and merge medical imaginginformation taken from the patient's mouth and/or dental castings of thepatient's mouth to create a patient-specific virtual models of thepreoperative and post-operative mouth and a surgical plan connecting thetwo models) or manually by dental art and hand (e.g., analogue dentaldesign and preparation).

This separation or compartmentalization of dental guide capabilitiescould result in higher costs, manpower, and surgical time that could befound than if the two dental guides could be combined into onemultipurpose device. The use of such a combination dental appliancecould accordingly lead to an increase in the affordability of suchdental procedures and results.

Another issue that may arise in such dental implant surgeries is whenthe dental healthcare professionals locate and affix the bone foundationguide physically upon the dental surgical site (e.g., a portion ofbone.) Generally, the dental healthcare professional has to juggle bothtasks of locating and affixing (e.g., drilling into the bone forfasteners, then using fasteners to secure the bone foundation guide ontobone) at the same time. The dental healthcare professional in havingjuggling both tasks may not properly locate the bone foundation guide indesired area of the dental surgical site; may not properly secure thebone foundation guide in place or both.

What could be needed is the present invention namely a bone foundationguide system substantially comprising of a combination of a bonefoundation guide used to modify bone structure from a dental implantsite (e.g., removing bone with a saw from the bone portion of the dentalsurgical site; adding bone or a bone analogue to the bone portion of thedental surgical site or both) and further supporting in a stackablemanner a dental implant surgical guide (e.g., for generally locatingimplants to the dental surgical site) and alternatively to the dentalimplant surgical guide a tissue spacing gasket (e.g., for properlylocating a prosthesis relative to the bone foundation guide.)

In one embodiment, a dental implant surgical guide be could removablyattached to the bone foundation guide in situ (e.g., after the bonefoundation guide has been used to modify a bone structure.)Substantially using the bone foundation guide as a base, the dentalsurgical implant guide could be used to generally position and locatethe implant components (e.g., drill, reamers, abutments, implantdrivers, etc.), dental implant or alike into the bone portion of thedental surgical site. Once the implant(s) are properly placed at thedental surgical site, the dental implant surgical guide could be removedfrom the bone foundation guide and be alternatively replaced with thetissue spacing gasket. In one possible embodiment, the tissue spacinggasket could be located between the bone foundation guide and aprosthesis to at least provide a basic approximation of gum tissuethickness for the gum that would normally cover that area of the dentalsurgical site to substantially allow for proper adjustment of prosthesisattachment to the implants and alike.

In one possible embodiment, the bone foundation guide could comprise ofa body and one or more removable anchoring struts that reversiblyconnect buccal and lingual walls of the body, an apex of the anchoringstrut could denote one or more indentations whose contours matching upwith one or more portions of dentition, tissue or both from an opposingalveolar ridge (e.g., the alveolar ridge that is generally locatedopposite of the alveolar ridge that is hosting the dental implant site)to allow the indentions to removably receive the one or more portions ofdentition, tissue or both from an opposing alveolar ridge. In thismanner, the patient can then press the patient's at least the one ormore portions of dentition, tissue or both of an opposing alveolar ridgeupon at least one of the one or more the anchoring struts removablyapplied to the body to initially hold the bone foundation guide in placeupon the dental surgical site. The patient's action could free theattending dental healthcare professional from having to hold the bonefoundation guide in place and substantially allow the said professionalto use both hands to secure the bone foundation guide in place withfasteners.

Another possible embodiment could further comprise a bone foundationguide prosthesis that is combined with a bone foundation guide. Theformed combination could be placed upon the exposed bone segment of thedental implant surgical site and accommodates that portion of theexposed bone segment that is to be subsequently removed during theimplant surgery. The patient could bite down upon the combination tobring the opposing first alveolar ridge into contact with thecombination. By observing the resulting bite, it can be determinedwhether or not the bone foundation guide is properly positioned upon theexposed bone segment. This observation could take into considerationseveral parameters such as telemetry, positioning orientation andaesthetics of the bite. The combination could further allow a directobservation of the fit between the combination and the exposed bonesegment.

In this manner, an in situ the bone foundation guide prosthesisinteraction with the opposing alveolar ridge relative to the dentalimplant surgical site prior to any irreversible bone removal from thedental implant surgical site. If proper bite alignment and alike doesnot exist then combination can be removed from the bone segment; gumtissue at the dental implant surgical site can be re-sutured and theimplant surgery can be postponed to allow for proper adjustments to bemade as necessary to correct the deviations or other imperfections thatcaused the bite misalignment and alike.

SUMMARY OF ONE EMBODIMENT OF THE INVENTION Advantages of One or MoreEmbodiments of the Present Invention

The various embodiments of the present invention may, but do notnecessarily, achieve one or more of the following advantages:

to provide an dental implant surgical guide that removably combines witha bone foundation guide to properly place a dental implant-retainedprosthesis to a dental surgical site in a manner that reduces patientstress and bruising that may occur than if the two guides were appliedseparately;

the ability to use a digital virtual model of patent mouth to design abone foundation guide wherein both the bone foundation guide and adental implant surgical guide can be conjoined in situ properly locate aone or more dental implants that could be used to locate and secure afixed dental prosthetic;

to provide a bone foundation guide and dental implant surgical guidethat can be combined together to substantially reduce cost, time andman-hours needed in a dental implant surgical procedure to properlylocate and attach a dental prosthetic to a dental surgical site;

the ability to use digital dentistry to control the design andmanufacture of a dental implant surgical guide-bone foundation guidecombination in a manner that digitally controls and refines the accuracyof the resulting bone foundation guide; dental implant surgical guideand a final fixed prosthetic; and

to provide a bone foundation guide that is used in conjunction with atissue spacing gasket, the tissue spacing gasket being used to helpproperly locate the placement of a prosthesis relative to the placeddental implant(s) by generally taking into account the height (or depth)of gum tissue that could normally cover the exposed bone at the dentalimplant surgical site;

the ability to design and manufacture a bone foundation guide systemwherein a dental implant surgical guide or a tissue spacing gasket thatcould alternatively could mate and interlock with the bone foundation togenerally allow implant components, dental implant or both to passthrough the assembled combination onto the bone at a dental surgicalguide;

to provide a dental surgical implant guide, bone foundation guide, andtissue spacing gasket to have matching contours and aligned openings andapertures that allow guides and gasket to be assembled into combinationsto properly locate and attach a fixed prosthetic to an implant at adental surgical site;

to provide one or more anchoring struts that could removably andtemporarily attach to the front and back of the base of a bonefoundation guide, each anchoring strut at a respective apex furtherdefine one or more indentations can reversibly receive one or moreportions of the tissue, dentition or both of an alveolar ridge that islocated opposite of an alveolar ridge that is supporting the dentalsurgical site;

the ability to have the patient bring one or more portions of thedentition, gum tissue or alike of an alveolar ridge into contact withthe anchoring struts to hold the bone foundation guide in place upon thedental surgical site located on the opposing alveolar ridge;

to provide anchoring struts that can be removed from the bone foundationguide after the bone foundation guide has been secured to the dentalsurgical site by fasteners;

the ability to have the patient temporarily hold the bone foundationguide in place upon the dental surgical site so as to free the dentalhealth care professional from holding the bone foundation guide in placeand being able to concentrate instead on securing the bone foundationguide to the dental surgical site with one or more fasteners;

to provide a bone foundation guide and a bone foundation guideprosthesis combination that can interact with both an opposing alveolarridge and the dental implant surgical site prior to removal of any bonefrom the dental implant surgical site to substantially provide a properfit of the bone foundation guide to the dental implant surgical site;

the ability to generally check the bone segment portion that is to beremoved from the dental implant surgical site prior to the bone segmentportion actually being removed from the dental implant surgical site;

the ability to substantially check the telemetry, orientation,positioning of a final prosthesis placement prior to removal of any bonefrom the dental implant surgical site; and

provide a bone foundation guide prosthesis that attaches by one or moreanchor struts to a bone foundation guide to accommodate a bone segmentportion of dental implant surgical site prior to the bone segmentportion being removed from the dental implant surgical site.

These and other advantages may be realized by reference to the remainingportions of the specification, claims, and abstract.

BRIEF DESCRIPTION OF ONE EMBODIMENT OF THE PRESENT INVENTION

One possible embodiment of the invention could be a bone foundationguide system comprising a bone foundation guide comprising a body havinga buccal wall and a lingual wall that is continuously connected by afirst end and a second end forming an open surgical space connecting atop of the body with a bottom of the body, the bottom is contoured toremovably affix the body to a bone segment of a dental implant surgicalsite, the body being further contoured to guide the cutting a portion ofthe bone segment from a dental implant surgical site and as well assupporting a dental implant surgical guide; a bone foundation guideprosthesis as an alternative to the dental implant surgical guide, thebone foundation guide prosthesis combines with the body to accommodatesthe bone segment portion as placed through the body prior to the bonesegment portion being removed from the dental implant surgical site.

Yet another embodiment of the invention could be a method of using abone foundation guide system comprising the following steps providing abone foundation guide comprising a body having a buccal wall and alingual wall that is continuously connected by a first end and a secondend forming an open surgical space that further connects a top of thebody with a bottom of the body, the bottom is further contoured toremovably receive at least a portion of a bone segment of a dentalimplant surgical site, the body further configured to at least removablysupport a dental implant surgical guide; providing a bone foundationguide prosthesis in alternative to the dental implant surgical guide toremovably attach to the body in a manner that accommodates the bonesegment portion as placed through the body prior to the bone segmentportion being removed from the dental implant surgical site; combiningthe body with the bone foundation guide prosthesis; and placing thecombination upon the bone segment of the dental implant surgical siteprior to the removal of any bone from the dental implant surgical site.

The above description sets forth, rather broadly, a summary of oneembodiment of the present invention so that the detailed descriptionthat follows may be better understood and contributions of the presentinvention to the art may be better appreciated. Some of the embodimentsof the present invention may not include all of the features orcharacteristics listed in the above summary. There are, of course,additional features of the invention that will be described below andwill form the subject matter of claims. In this respect, beforeexplaining at least one preferred embodiment of the invention in detail,it is to be understood that the invention is not limited in itsapplication to the details of the construction and to the arrangement ofthe components set forth in the following description or as illustratedin the drawings. The invention is capable of other embodiments and ofbeing practiced and carried out in various ways. Also, it is to beunderstood that the phraseology and terminology employed herein are forthe purpose of description and should not be regarded as limiting.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is substantially a perspective bottom side view of one possibleembodiment of the bone foundation guide the invention.

FIG. 2 is a top side perspective view of one possible embodiment ofanchoring strut of the present invention.

FIG. 3 is a bottom side perspective view of one possible embodiment ofanchoring strut of the present invention.

FIG. 4 is substantially a bottom side perspective view of one possibleembodiment of the body. to [0049] FIG. 5 is substantially a perspectivetop side view of one embodiment of the bone foundation guide.

FIG. 6 is substantially a bottom elevation view of one embodiment of thebone foundation guide.

FIG. 7 is substantially a flow chart schematic showing a method of usingthe invention.

FIG. 8 is substantially an elevation view of patient's mouth showingexposed bone portion of the dental surgical site.

FIG. 9 is substantially an elevation view of patient's mouth showingexposed bone portion of the dental surgical site in an edentulouspreoperative state.

FIG. 10 is substantially a perspective front view of one embodiment ofthe bone foundation guide with struts being applied to the dentalsurgical site.

FIG. 11 is substantially a front perspective view of the bone foundationguide with struts being bitten down upon by the patient.

FIG. 12 is a front perspective view of the bone foundation guide withstruts with the patient releasing its grip on the bone foundation guideand the strut fasteners being removed.

FIG. 13 is substantially a front perspective view of the bone foundationguide with struts, the strut fasteners being removed from the respectivestrut.

FIG. 14 is substantially a front perspective view of the bone foundationguide with struts, the strut being removed the bone foundation guidebody.

FIG. 15 is substantially a front perspective view of the bone foundationguide with struts removed and the harvested bone being removed from thedental surgical site.

FIG. 15A is substantially a bottom elevation view of the bone foundationguide with struts and the harvested bone removed from the dentalsurgical site.

FIG. 16 is substantially an underside elevation view of the bonefoundation guide with struts removed and the harvested bone removed fromthe dental surgical site

FIG. 17 is substantially an underside perspective view of thecombination bone foundation guide and dental implant surgical guidecombination.

FIG. 18 is substantially an underside elevation view of the combinationbone foundation guide and dental implant surgical guide combination.

FIG. 19 is substantially a cutaway, perspective view of the combinationbone foundation guide and dental implant surgical guide combination.

FIG. 20 is substantially a perspective view of the tissue spacer gasket.

FIG. 21 is substantially a perspective view of the bone foundation guidewith abutments attached to the implants.

FIG. 22 is substantially a perspective view of the bone foundation guideand tissue gasket combination.

FIG. 23 is substantially a perspective view of the prosthesis applied tothe bone foundation guide and tissue gasket combination.

FIG. 24 is substantially a perspective view of the dental surgical sitewith the bone foundation guide, tissue gasket and prosthesis removed.

FIG. 25 is substantially a perspective view of the dental surgical sitewith the bone foundation guide, tissue gasket and prosthesis removed andgum tissue sutured back into place at the dental surgical site.

FIG. 26 is substantially a perspective view of the dental surgical sitewith gum tissue sutured back into place and prosthesis relocated uponthe implants.

FIG. 27 is substantially a perspective view of the bone foundation guideprosthesis, the prosthesis being unitary with the anchoring struts.

FIG. 28 is substantially a perspective view of the bone foundation guideprosthesis being non-unitary with the anchoring struts.

FIG. 29 is substantially a perspective cutaway view of the bonefoundation guide prosthesis being combined with the bone foundationguide.

FIG. 30 is substantially a perspective view of opposing alveolar ridgebrought into contact with the bone foundation guide prosthesis and thebone foundation guide combination.

FIG. 31 is substantially a perspective view of the bone foundation guideprosthesis and denture base combined to form a denture.

FIG. 32 is substantially a perspective view of multiple piece fastenerthat can connect a strut to the buccal wall and the buccal wall to thebone segment of the dental implant surgical site to allow a subsequentremoval of the strut from the bone foundation guide while retaining theattachment of the buccal wall to the bone segment.

DESCRIPTION OF CERTAIN EMBODIMENTS OF THE PRESENT INVENTION

In the following detailed description of the preferred embodiments,reference is made to the accompanying drawings, which form a part ofthis application. The drawings show, by way of illustration, specificembodiments in which the invention may be practiced. It is to beunderstood that other embodiments may be utilized and structural changesmay be made without departing from the scope of the present invention.

The present invention 10 could be a bone foundation guide system 18 andmethod or process 100. As substantially shown in FIGS. 1, 17, and 19 thebone foundation guide system 20 could comprise a bone foundation guide20, a dental implant surgical guide 50 and in at least one embodiment, atissue spacing gasket 80 as well. The bone foundation guide body 22, thedental implant surgical guide 50 and tissue spacing gasket 80 may bedesigned and created together through digital dentistry in which scansof the patient's mouth 35 (along with impressions and castings thereof)may be used to create a virtual model (not shown) of the patient'sexisting mouth; to develop a virtual model of the patient's mouth bothpre-dental and post-dental surgery; and to develop a dental surgicalplan that connects the two patient-specific virtual models. In thismanner, the dental surgical planning can provide for the manufacture thebone foundation guide 20, dental implant surgical guide 50 and tissuespacing gasket 80 so that the contours of the bone foundation guide body22 may be created to fit upon the exposed bone 14 of the dental surgicalsite 12. Further, the dental implant surgical guide 50 contours may alsomatch those of the dental implant surgical guide 50 and the tissuespacing gasket 80 to enable dental implant surgical guide 50 and thetissue spacing gasket 80 to alternately be removably attached to and besupported by the bone foundation guide 20.

As substantially shown in FIGS. 1, 2, 3, 4, 5 and 6 the bone foundationguide 20, as substantially used by a dental healthcare professional suchas a dental surgeon (not shown) to substantially modify (e.g., reduce,augment or both) the bone 14 of the dental surgical site 12 as neededfor a successful dental surgery. The bone foundation guide 20 couldcomprise a bone foundation guide body 22 with a buccal wall 24 andlingual wall 26 connected together at their respective ends by a firstend 28 and a second end 30. The first end 28 and the second end 30 couldbe holding the buccal and lingual walls 24, 26 apart from one and otherin a substantially parallel fashion to generally create and define anopen surgical space 32 (e.g., that generally passes through the bonefoundation guide body 22) to generally continuously connect a portion ofthe top 34 of the body 22 with a portion of the bottom 36 of the body22.

The bone foundation guide body 22 may be further penetrated by one ormore attachment apertures 38 that may be oriented to pass through abuccal 24 wall. Body fasteners 40 may pass through the attachmentapertures 38 to into the bone 14 of the dental surgical site 12 toremovably secure the bone foundation guide body 22 to dental surgicalsite 12. (Substantially shown in FIG. 13.) The attachment aperture 38could further feature a reinforcement collar (not shown) to support andguide the fastener 40 through the attachment aperture 38. In otherembodiments, the attachment apertures 38 could pass though the body 22connecting top 34 and bottom 36 or through the lingual wall 26 toprovide body attachment to the dental surgical site 12. The body mayfurther have a cutting guard 23 extending up from the top of the lingualwall 26 to prevent a cutting implement (not shown) when used with thebone foundation guide in removing bone 14 from a dental surgical sitefrom unwantedly cutting the tongue or other portions of the patient'smouth 19. This cutting guard 23 may further feature out or more cutouts25 that may be used to anchor and align other portions.

Some embodiments of the the bone foundation guide body 22 may furthercomprise of a one or more anchoring struts 42 that may be removablyattached to the buccal wall 24 and the lingual wall 26 between the firstend 38 and the second end 30. The anchoring strut 42 may have at itsouter apex 44 one or more indentations 46 that can match one or moreportions of gum, dentition or both the patient's first or opposingalveolar ridge 28 (e.g., the opposing alveolar ridge 13 is locatedopposite of or opposing to the second alveolar ridge 15 that issupporting the dental surgical site 12. Meaning if the dental surgicalsite 12 is on the upper alveolar ridge then the opposing alveolar ridge28 could be the lower alveolar ridge.) The front end 43 of anchoringstruts 42 may be penetrated by strut apertures 47 that allow strutfasteners 49 (e.g., tapered pins) to penetrate through the anchoringstrut 42 to the buccal wall 24. The strut fasteners 49 may removablyattach to the anchoring strut 42 by the buccal wall 24 and be held inplace by frictional force. The other or rear end 41 of the anchoringstrut 42 may have a strut groove 48 that fits over a respective cutout25. A tab 45 within the strut groove 48 may be removably received withinthe respective cutout 25 to further reversibly attach the rear end 41 tothe cutting guard 23.

The anchoring strut 42 may allow the patient itself press at least aportion of gum tissue, dentition or both of the opposing alveolar ridge13 upon at least one anchoring strut 42 of the bone foundation guide 20to generally hold the bone foundation guide 20 in place upon the dentalsurgical site 12 (e.g., the exposed bone.) In particular, that portionof gum tissue, dentition or both of the opposing alveolar ridge 13 couldbe received with the indentation(s) 46. The patient's action (e.g.,substantially clamping down with patient's mouth upon the bonefoundation guide 20 in situ could allow the patient to temporarily andremovably hold the bone foundation dental upon the dental surgical sitewhile the dental health care professional (not shown) is free to useboth hands to attach the bone foundation guide 20 in place with bodyfasteners. Once the bone foundation guide 201 is secured by bodyfasteners 40 to the bone portion of the dental implant surgical site 12,the patient could remove one or more portions of the opposing alveolarridge 28 from the one or more indentations 46 upon the one or moreanchoring struts 42 (e.g., the patient opens its mouth to stop bitingupon the anchoring struts 42.) The dental health care professional canthen proceed with the removal of the strut fasteners 49 from the bonefoundation guide 20 so as to be able to lift the anchoring struts 46free and clear from the body 22.

The use of anchoring struts 42 can also be applied to bone reductionguides that lack the present inventions ability to combine or stacktogether with the dental implant surgical guide or tissue spacinggasket. In such instances, bone reduction guides are not contoured toaccept the dental implant surgical guide or tissue spacing gasket butcould have a body to which the anchoring struts 42 are applied to allowthe patient to substantially clamping down with patient's mouth upon thebone reduction guide in situ could allow the patient to temporarily andremovably hold the bone reduction guide upon the dental surgical site.The portions of dentition, teeth or both of the opposing alveolar ridgecould be received with the impressions located upon the apex ofanchoring struts 42 to hold the bone reduction guide in place while thedental health care professional (not shown) is free to use both hands toattach the bone reduction guide in place with fasteners to the dentalsurgical site. Once the fasteners have secure the bone reduction guideto the dental surgical site, the patient could release its bite upon theanchoring struts. The dental healthcare professional can then remove theanchoring struts 42 from the body of the bone reduction guide to allowthe bone reduction guide to be used to alter bone structure at thedental surgical site.

As substantially shown in FIGS. 16, 17, 18, and 19 once the anchoringstrut(s) 42 are removed from the bone foundation guide body 22, thedental implant surgical guide 50 could be removably attached to the top34 of the body 22. The dental implant surgical guide 50 could be soanchored to dental surgical site 12 to generally allow dental implantsurgical guide 50 to be substantially be used to guide and locate theplacement of dental implants within dental surgical site 12.

The dental implant surgical guide 50 could comprise a dental surgicalguide body 20 having a first end side 52 and second end side 54 thatterminates the dental surgical guide body 52 and along with a top side58 and a bottom side 60 that continuously connect a buccal side 62 witha lingual side 64. The bottom side 60 of the dental implant surgicalguide 50 can be digitally designed and manufactured to have a contourthat substantially matches and removably accepts the top 34 of the bonefoundation guide 20. The top 34 of the bone foundation guide body 22 mayalso be digitally designed and created to substantially match and toreceive the bottom side 60 of the reciprocal dental surgical guide body52 to allow the conjoining of the two guides 20, 50 in a stackablemanner so that the bone foundation guide 20 acts as a base or foundationfor the dental implant surgical guide 50.

The dental surgical guide body 52 can be further penetrated by one ormore implant apertures 66 that could continuously connect the top side58 to the bottom side 60 to guide implant preparation and attachment tothe dental operation site 12. The dental surgical guide body 52 toremovably attach to the body 22 could utilize a wide variety ofattachment means. One such possible attachment means could make use oneor more guide pins 70 and one or more guide tabs 71 and their frictionalinterplay with the body 22. The guide pins 70 could protrude out fromthe bottom side 60 by the buccal wall 62 to be removably received withinpin apertures on the top 34 of the body 22 along the buccal wall 24. Theone or more guide tabs 71 could extend outwards from the lingual side 64to be respectively received by the cutouts 25 of the cutting guard 23.The guide tabs 71 and guide pins 70 along with the lingual side 64matching the contour of the cutting guard 23 could provide a snap-in fitof the dental implant surgical guide 50 to the bone foundation guide 20.

The conjoining or stacking capability of the two guides 20, 50 couldalleviate the need to remove the bone foundation guide 20 from thedental surgical site 12 prior to attaching the dental implant surgicalguide 50 to the dental surgical site 12 as well as alleviate the need toattach the dental implant surgical guide 50 directly to the dentalsurgical site 12 and the like. This combining of the two guides 20, 50could also reduce the time, money, effort, patient discomfort and alikethat would otherwise occur if the guides 20, 50 were used separatelyfrom one and other. When so combined together, the dental implantsurgical guide 50 generally surrounds the bone foundation guide's opensurgical space 32 to allow implant components, implants or both to passthrough the dental implant surgical guide's implant aperture(s) 66 andon through the of the open surgical space 32.

As substantially shown in FIGS. 20, 21, 22 and 23, one other possibleembodiment of the invention 10 could further comprise a tissue spacinggasket 80 that can be alternatively used with the bone foundation guide50 instead of the dental implant surgical guide 50 or the anchoringstrut(s) 42. The tissue spacing gasket 80 could fit between the bottom36 of the bone foundation guide 20 and the dental surgical site 12 toallow the proper placement of prosthesis 21 upon the placed implants byproviding an approximation of the distance or thickness of the gumtissue 16 that otherwise covers the dental surgical site 12. Theplacement of the tissue spacing gasket 80 upon the bone foundation guidetop 34 where the tissue spacing gasket 80 is generally sandwichedbetween the bone foundation guide 20 and the prosthesis 21 could allowthe tissue spacing gasket 80 provide additional benefits besidescorrecting for thickness of the missing (e.g., peeled back) gum tissue16. The tissue spacer guide 80 could help cradle the prosthesis andmaintain the prosthesis proper vertical and centric positions as theprosthesis is being fixed upon the implants. When the prosthesis 21 isgenerally fixed about the implants (e.g., to the abutments 17 attachedto the implants), dental acrylic could be injected into the prosthesisto secure implant abutments to the prosthesis. The tissue spacing gasket80 could help block out the undercut of the abutments 17 to generallyprevent the acrylic from reaching the undercuts and thus preventingunwanted or premature attachment of the prosthesis to the implants 17.The tissue spacing gasket 80 could further prevent acrylic from reachingand contaminating the exposed bone 14.

The tissue spacing gasket 80 could be made from a pliable polymer thatforms a gasket top 84 upon which the prosthesis could rest and to agasket bottom 82 which is reversibly received by the bone foundation top34, the gasket top 84 and the gasket bottom 84 being continuallyconnected by one or more gasket apertures 86. The one or more gasketapertures 86 could have the same alignment and size of the implantapertures 66 of the dental implant surgical guide 50. In at least oneembedment, the tissue spacing gasket 80 could denote a gasket opensurgical space (not shown) that continuously connects gasket top 84 andgasket bottom 82, the gasket open surgical space generally matching thefootprint of the bone foundation guide's open surgical space 32.

To generally removably affix the tissue spacing gasket 80 to the bonefoundation guide 20, the tissue spacing gasket 80 could have one or moregasket pins that protrude from the gasket bottom 82 and could beremovably received within apertures on the bone foundation guide top 34by the buccal wall 24 that received guide pins 70. The tissue spacinggasket 80 could further have the gasket tabs 88 that could be removablybe received within the cutting guard cutouts 25. The tissue spacinggasket tabs 88 could generally match the size, placement and orientationof the dental implant surgical guide's guide tabs 71.

As substantially shown in FIGS. 27-30, another possible embodiment ofthe invention 10 could further comprise a bone foundation guideprosthesis 200 that can be removably combined with the body 22 of thebone foundation guide to form a bone foundation guide prosthesis-bodycombination 202. The combination 202 can be applied to the unalteredbone segment 14 of the dental implant surgical site 12 and can furthercan be used in contact with the first alveolar ridge 13 that is opposingto the dental implant surgical site 12 to check the placement of thebone foundation guide 20 upon bone segment 14 of the dental implantsurgical site 12. As the respective patient bites upon the combination,the opposing or first alveolar ridge 13 (e.g., opposing teeth) could bebrought into contact with the teeth portion 204 of the bone foundationguide prosthesis 200.) The various parameters (e.g., orientation,telemetry, positioning, aesthetics, and the like) as presented by theopposing alveolar ridge-to-bone foundation guide prosthesis bite 206could reflect (e.g., generally act as an analogue representation) thefinal prosthesis-to-opposing first alveolar ridge bite. This bitecompression could also ensure solid contact of the combination 202 uponthe bone segment 14 of the dental implant surgical site 12 prior to anybone removal by use of the bone foundation guide 20. If the observedparameters or the bone foundation guide-to-bone segment fit show anysignificant departure or inconstancy with the surgical dental implantplan, the dental implant surgery could be halted prior to anyirreversible bone alteration at the dental implant surgical site 12. Thecombination 202 can then be removed from the dental implant surgicalsite 12 (e.g., the bone segment 14) and the gum tissue can be re-suturedat the dental implant surgical site 12 to allow greater time toreformulate the associated surgical dental implant plan to take intofurther consideration those factors that caused the departure orinconsistency in the first place.

As substantially shown in FIG. 31, in one possible version once the bonefoundation guide prosthesis (or suitable portion thereof) 200 is removedfrom the body 22, the tooth portion 204 of the multiple piece ornon-unitary version of bone foundation guide prosthesis 200 could befurther combined with a denture base 208 to form a denture 210. In thatcases where the implant surgery was halted due to bite misalignmentbetween the first alveolar ridge (not shown) and the bone foundationguide prosthesis 200, the denture 210 could then be used by the torespective patient (not shown) until proper adjustments had been made asnecessary to correct the deviations or other imperfections that causedhalting of the implant surgery that could allow the dental implantsurgery to proceed forward again.

The bone foundation guide prosthesis 200 could be comprise the teethportion 204 having a top side 212 substantially replicating the teeth orthe bite of the final prosthesis (not shown) and a bottom side 214 thatcould support one or more anchor struts 42. The bottom side 214 couldfurther define cutouts 216 that allow a visible inspection of the bonesegment 14 where the bone segment 14 comes into contact with the bonefoundation guide prosthesis 200 (e.g., one or more undersides 215 of theanchor struts 42 could be contoured to receive and contact a portion ofthe bone segment 14). In one possible embodiment, the bone guidefoundation prosthesis bottom 214 could limit the bone segment contact tothree points of contact to substantially prevent rocking of the boneguide foundation prosthesis 200 upon the bone segment 14.

Removable attachment of the struts 42 to the body 22 could assist theattachment of the bone foundation guide prosthesis 200 to the bonefoundation guide 20. The bone foundation guide prosthesis 200 could haveone or more support tabs 220 proximate to each end of the bonefoundation guide prosthesis 200 that could be removably received withincorresponding support slots 220 in the lingual wall cutting guard 23.Proximate to the rear end 41 of the anchor strut 48 could feature asecuring tab 228 that could removably attached to a correspondingsecuring slot 230 also formed in the lingual wall cutting guard 23.

At least one anchoring strut 48 could have its front end 43 form anattachment tab 222 that fits into a respective tab slot 224 formed bythe body's buccal wall 24 that could be accessed at the top 34. Both theattachment tabs 222 and their respective attachment slots 224 could besuitably angled to assist the attachment and removal of the bonefoundation guide prosthesis 200 as the bone foundation guide prosthesis220 moves over the buccal wall 24 for attachment or removal. A fastenerchannel 226 could traverse the buccal wall 24 and the attachment tab 222(when inserted into the tab slot 224) to allow removable placement of astrut fastener 49 (not shown) placed into the fastener channel 226 tohelp hold the anchoring 42 strut to the top 34 of the buccal wall. Itshould be noted that it may not be necessary for each anchoring strut 42to have support tab-support slot attachment capability.

As substantially shown in FIG. 27, one possible version of the bonefoundation guide prosthesis 200 could have the teeth portion 204 beunitary or one-piece with the one or more struts 48 substantiallyproviding strength and rigidity to the combination 202. In anotherversion as substantially shown in FIG. 28, the one or more anchor struts42 are removably attached to the bottom 214 of the bone foundation guideprosthesis 200. Friction fit based tab-slot coupling means could beutilized to removably attach the removable anchor struts 42 to the bonefoundation guide prosthesis 200.

As substantially shown in FIG. 32, one possible embodiment the strutfastener 49 could be a multiple piece strut fastener 232 that could bothhold the strut front end 43 to the buccal wall 24 as well as secure thebuccal wall 24 to the bone segment 14. The multiple piece strut fastener232 could have a taper pin 234 comprising a head 236 that could furtherform a threaded receptacle 238. The threaded receptacle 238 couldremovably receive a part of a threaded portion 240 of a threadedfastener 242 to removably connect the taper pin 234 to the threadedfastener 242. The fastener head 246 could be larger in diameter than thehead 236 of the tapered pin 234 to allow shoulders 248 as provided bythe stepped configuration of the fastener channel 226 to support thehead 236 of the tapered pin 234. The fastener head 246 could have aserrated edge 250 to allow a pliers or like (not shown) to grasp thethreaded fastener 242 to pull out combined threaded fastener and taperpin from the fastener channel 226 (e.g., and from contact the bonesegment 12, attachment tab 222, buccal wall 24 and lingual wall 26.) Theremoval of just the threaded fastener 242 only could leave the taperedpin 234 in place to secure the body 22 to the bone segment 12 whileallowing the bone foundation guide prosthesis 200 to be removed from thebody 22. A cylinder 252 could be placed on the threaded portion 240 ofthe threaded fastener 242 to assist the threaded fastener's placementinto the fastener channel 226.

As substantially shown in FIGS. 7-26, one possible method or process 100for the use of the invention could start with step 102, digital scanningand modeling for the patient-specific dental surgery. In this step,dental digital methods (digital dentistry) may be used in creatingpatient-specific map of the patient's mouth (which could include thedigital scanning of analogue appliances such as patient specificcastings and impressions); in creating models for patient-specific boneremodeling (e.g., foundation and re-contouring) of the upper and/orlower dental struts in the patient's mouth; in creating models fordental implant surgical guides/bone foundation guides and prostheticsused post-patient-specific bone remodeling; in creating a patientspecific model of the patient's mouth post dental surgery. After thisstep is substantially completed, the process 100 could proceed to step104, creation of the guides, tissue spacing gasket and other dentalappliances.

In step 104, creation of the guides and other dental appliances, theacquired and processed modeling data can be used to create thepatient-specific bone foundation guide (e.g., d patient-specific bonefoundation guide, tissue spacing gasket and dental implant surgicalguide that be stacked together in various combinations. The anchoringstruts can also be patient-specific made to have indentations at theirrespective apexes to match various portions of the dentition, tissue orboth of the opposing alveolar ridge. Once manufactured, the anchoringstruts could be removably attached to the bone foundation body. Thestrut fastener (e.g., a tapered pin) could removably attach theanchoring strut's front end to the buccal wall. The strut rear end couldremovably straddle the cutting guard's respective cutout with the strutgroove allowing the strut groove's tab to be removably received withinthe cutout.

The design and manufacturing imparted stacking capability could allowthe two guides and gasket to come together to various stackedcombinations. This stacking capability allows the bone foundation guide,once removably secured to the dental surgical site by the dental healthcare profession, to generally act as foundation for the dental implantsurgical guide or the spacing tissue gasket to secure them alternatelyto the dental surgical site. This stacking capability could allow theimplant, implant components, implant instruments and the like to beguided through the dental implant surgical guide implant apertures andthe bone foundation guide's open surgical space to properly interactwith the dental surgical site. After this step is substantiallycompleted, the process 100 could proceed to step 106, surgical prep.

In step 106, surgical prep, the dental health care professional could(after properly anesthetizes the patient and instituting other requireddental surgical pre-operation protocols) could make incisions in the gumarea of the dental surgical site, and peel back the gum tissue to exposethe portion of bone being operated upon at the dental surgical site. Anyteeth at the dental implant surgical site can be removed. If thepatient's dental health has declined enough, the alveolar ridgesupporting the dental surgical site could be made edentulous After thisstep is substantially completed, the process 100 could proceed to step108, use of the bone foundation guide.

In step 108, use of the bone foundation guide, the bone foundation guidecould be removably attached to the bone foundation guide prosthesis togenerally form the bone foundation guide-bone foundation guideprosthesis combination. For the non-unitary version of the bonefoundation guide prosthesis, the anchoring struts could then be attachedto the bottom of the teeth portion. The anchoring struts (both forunitary and non-unitary versions of the bone foundation guideprosthesis) could then be moved into place over the bone foundationguide body so that support tabs on the teeth portion and securing tabsnear the rear end of the anchoring struts can removably engage theirrespective slots formed by the lingual wall cutting guard. The frontends of the struts can then be swung down upon the top of the buccalwall of the body of the bone foundation guide to respectively engage theattachment tabs with the attachment tab slots formed by the buccal wall.Suitable fasteners can then be placed into the fastener channels toremovably secure the attachment tabs in their respective attachmentslots to generally hold the bone foundation guide prosthesis in placeupon the body to form the combination. The dental healthcareprofessional can then initially set the combination upon the bonesegment of the dental implant surgical site without first having toremove or alter the bone segment.

The patient could “bite” upon the bone foundation guide prosthesis tobring the opposing alveolar ridge (e.g., the opposing the dentition,tissue or both) into contact with the teeth portion of the combination.By biting upon the combination, the patient generally holds the bonefoundation guide initially in place upon the dental implant surgicalsite. This bite compression could allow the dental healthcareprofessional to view the resulting bite of the teeth portion andopposing alveolar ridge to help ensure that as the surgical plan iscarried out that the final (e.g., implant attached) prosthesis will havethe same bite and lockup as one shown by the bone foundation guideprosthesis. This allows the dental healthcare professional to examinethe bite as well as resulting orientation, telemetry, positioning,aesthetics and the like as generally provided by the bite. Further, thedental healthcare professional can examine the bone segment andcombination interface located below the teeth portion and between theanchoring arches to make sure the combination is properly set upon thebone segment. The dental healthcare professional may also use thecutouts to further examine the bone segment-combination interface.

If the alveolar ridge-teeth portion bite does not result in proper ordesired telemetry, positioning, orientation, aesthetics; if thecombination cannot fit properly upon the bone segment or both then thedental implant surgery can be halted until such deficiencies can beproperly rectified. At that point, the combination can be removed fromthe bone segment, and gum tissue can be re-sutured up to cover theexposed bone segment. If non-unitary version of the bone foundationguide prosthesis is used, then the teeth portion can be removed from thearches and body. The teeth portion can be attached (e.g., glued orcemented) to a denture base to form a denture. The patent can then usethe formed denture until corrections have been made to the aspects ofthe dental implant surgical plan, models and alike to allow the dentalimplant surgery to resume.

If the alveolar ridge-teeth portion bite results in proper or desiredtelemetry, positioning, orientation, aesthetics and if the combinationfits properly upon the bone segment or then dental implant surgery canproceed with the dental healthcare professional with both hands free touse a drill to make channels in the dental surgical site (e.g., theexposed bone portion) utilizing the attachment apertures. Body fastenersare placed into the attachment apertures and channels to generallyremovably attach the bone foundation guide to the exposed bone at thedental surgical site. If multiple piece fasteners are used, thosefasteners can further secure the through the fastener attachment of thebuccal wall through the bone segment to the lingual wall of the bonefoundation guide. The dental healthcare professional askes the patientto relax its grip upon the bone foundation guide to generally bring theportion of the dentition, tissue or both of the opposing alveolar ridgeout of contact with the indentation(s). When the anchoring struts arecleared from the body (e.g., the threaded fasteners are removed), thebone foundation guide prosthesis could be removed from the bonefoundation guide.

The removal of bone foundation guide prosthesis could clear the bonefoundation guide to allow the bone foundation guide top to be used toguide a cutting implement (e.g., blade saw) to reduce the dental implantsurgical site's bone structure. The harvested bone (e.g., or boneanalogue) could then be used to augment the dental surgical site ifneeded. Known dental techniques for reducing or augmenting the bonecould be employed to provide the proper bone contour for the dentalimplant surgical site. Once this step is substantially completed, theprocess 100 could proceed to step 110, use of the dental implantsurgical guide.

In step 110, use of the dental implant surgical guide, the dental healthcare professional could place the bottom side of the dental implantsurgical guide upon the top of the bone foundation guide generallyenclosing the open surgical space. In one embodiment, the tissue spacinggasket is sandwiched between the bone foundation guide and the dentalimplant surgical guide. Pins on the underside of the dental implantsurgical guide could attach to the attachment apertures in the bonefoundation guide top (e.g., by the buccal wall) while the guide tabsextending out from the lingual side could removably engage the cuttingguard cutouts to provide a snap fit of the dental implant surgical guideinto the bone foundation guide.

The dental healthcare professional could use the bone foundation guideand the dental implant surgical guide stacked or otherwise combinedtogether to substantially direct and operate implant preparationimplements (e.g., drills, reamers, and the like), implant components, orboth by passing them through the dental implant surgical guide and intothe open surgical space to properly prepare the dental surgical site toreceive the implant(s) This implant preparation could ensure there wasproper orientation and telemetry of the implant components and implantsinto the generally exposed bone of the dental surgical site. Once thebone is properly prepared to receive the implants, the implant(s) couldthen pass through the combination to be anchored into the bone. Oncethis step is substantially completed, the process 100 could proceed tostep 112, using tissue spacing gasket.

In step 112, using tissue spacing gasket, once the implants wereproperly located and set within the dental surgical site, the surgicalimplant dental guide could be removed from the bone foundation guide andthe tissue spacer gasket could alternatively be connected to the bonefoundation guide. In one embodiment, the pins located on the gasketbottom can be generally be removably received in the same apertures onthe bone foundation guide top that the accommodated the guide pins ofthe dental implant surgical guide.

In one possible embodiment, once the tissue spacing gasket is removablyattached to the bone foundation guide then temporary abutments can beplaced upon the implants. A temporary prosthesis can be placed over thetissue spacer gasket to come into contact the temporary abutments. Thetissue spacing gasket could cradle the temporary prosthesis at thispoint holding it in the proper vertical and concentric orientation asdental acrylic is injected into the temporary prosthesis to secure theabutments to the temporary prosthesis. The tissue spacing gasket mayfurther prevent the acrylic from leaking upon and contaminating theexposed bone. The tissue spacing gasket may as well as prevent anyacrylic leaking onto the abutment undercut (e.g., to generally preventedunwanted premature attachment of the prosthesis to the implants.) Thetissue spacing gasket may help to insure that proper distance betweenbone and prosthesis is maintained to account for presence of tissue whenthe gum tissue is placed back over the bone.

Once the acrylic has set, the above abutment prosthesis attachmentprocess may repeated used for a clear or analogue prosthesis that latercan be sent back to the lab. The analogue prosthesis with its affixedabutments may be applied to implant bone model that was devised throughthe dental model to see how the dental healthcare professional may havedeviated from the original dental surgical plan in attaching theimplants to the dental surgical site. In that manner, the analogueprosthesis will allow the final changes of the actual dental surgery (onsite changes made by the dental healthcare professional to take intoaccount issues not foreseen by the dental surgical plan) to be impartedonto the dental model and to the final prosthesis.

Once the temporary prosthesis (and analogue prosthesis) is removed fromthe tissue spacing gasket-bone foundation guide combination, the tissuespacing gasket could be removed from the bone foundation guide. The gumtissue flaps could be sutured back over the exposed bone (but notnecessarily over the implants) and the temporary prosthesis could bereattached to the implants. As the dental surgical site heals and theimplants further incorporate themselves into the bone structure, thetemporary prosthesis could help maintain the implant positioning as setduring the surgery, so that the permanent prosthesis should be able toreplace the temporary prosthesis with minimal adjustment and fitting.

This process 100 could also allow as needed, use of temporary cylinder,associated seals, additional filling, and other sealing methods that maybe used to properly prepare the dental implant for the attachment ofprosthesis and the like. If healing abutments are used instead, thenthey can be fitted to the implants as needed. The gum tissues can thenbe sutured or otherwise cover-up the exposed bone to meet up with theabutment/implants. If the gum tissues need to heal or need to healaround the healing abutments or the implants require ossification tosecure them in place to the bone, then after these event(s) haveoccurred/or a suitable amount of healing time has passed then the finalprosthesis (or prosthetic) could be placed upon the implants in a securefashion. After this step is substantially completed, the process 100could proceed back to step 102 as needed.

CONCLUSION

Although the description above contains many specifications, theseshould not be construed as limiting the scope of the invention but asmerely providing illustrations of some of the presently preferredembodiments of this invention. Thus, the scope of the invention shouldbe determined by the appended claims and their legal equivalents ratherthan by the examples given.

As shown in the specification, drawings, claims and abstract, theinvention, a bone foundation guide provides for the combining a bonefoundation guide and a bone guide foundation prosthesis and a method ofuse for the resulting combination. The prosthesis can have a teethportion representing a bite of a final prosthesis as well as one or moreanchoring struts that removably attach the prosthesis to the bonefoundation guide. The patient could apply the opposing alveolar ridge tothe teeth portion to hold the combination in place upon the bone segmentof the dental implant surgical site as well as check the bite of theteeth portion and alveolar ridge. The action allows the dentalhealthcare professional check in situ the representation or analogue offinal prosthesis with opposing alveolar ridge to detect anyinconsistency or deviation from the dental implant surgical plan. If anyinconsistence or deviation is detected, the combination can be removedfrom the dental implant surgical site prior to any bone removal; the gumtissue can be re-sutured and the patent can use a denture formed fromthe teeth portion attached to a denture base while inconsistence ordeviation are being suitably addressed. If no significant deviation orinconsistency is detected, the dental implant surgery can proceed withthe attachment of the combination to the dental implant surgical site;the removal of the prosthesis from the bone foundation guide; and theremoval of bone from the dental implant surgical site.

1.-20. (canceled)
 21. An apparatus, comprising: (a) a bone foundationguide, the bone foundation guide having an arcuate configurationconfigured to complement a first alveolar ridge of a patient, whereinthe bone foundation guide comprises: (i) a first surface configured toface away from the first alveolar ridge when the bone foundation guideis secured to the first alveolar ridge, (ii) a second surface positionedadjacent to the first surface, (iii) a third surface positioned adjacentto the second surface and opposite to the first surface, the thirdsurface being configured to face toward the first alveolar ridge whenthe bone foundation guide is secured to the first alveolar ridge, and(iv) a plurality of openings extending from the first surface to thethird surface, the openings being configured to receive fasteners tosecure the bone foundation guide to the first alveolar ridge; and (b) aprosthesis, wherein the prosthesis comprises: (i) a first engagementportion configured to engage the second surface of the bone foundationguide to thereby enable the prosthesis to be mounted to the bonefoundation guide, (ii) a second engagement portion configured to engagea second alveolar ridge of the patient when the prosthesis is mounted tothe bone foundation guide and the bone foundation guide is secured tothe first alveolar ridge, and (iii) a space configured to receive boneof first alveolar ridge when the prosthesis is mounted to the bonefoundation guide and the bone foundation guide is secured to the firstalveolar ridge.
 22. The apparatus of claim 21, the second surface beingconfigured to face toward the second alveolar ridge when the bonefoundation guide is secured to the first alveolar ridge.
 23. Theapparatus of claim 21, the prosthesis further comprising at least oneopening configured to align with a corresponding opening of theplurality of openings of the bone foundation guide.
 24. The apparatus ofclaim 23, the at least one opening of the prosthesis being configured toreceive a fastener to secure the prosthesis to the bone foundationguide.
 25. The apparatus of claim 21, the first engagement portioncomprising at least one strut extending between the second engagementportion and the bone foundation guide.
 26. The apparatus of claim 21,the second engagement portion comprising a replication of one or moreteeth.
 27. The apparatus of claim 21, the space being configured toenable visualization of at least a portion of the bone of first alveolarridge when the prosthesis is mounted to the bone foundation guide andthe bone foundation guide is secured to the first alveolar ridge. 28.The apparatus of claim 21, the first engagement portion furthercomprising a tab.
 29. The apparatus of claim 28, wherein the bonefoundation guide further comprises a slot configured to receive the tab.30. The apparatus of claim 29, wherein the bone foundation guide and thetab further define corresponding openings configured to receive afastener to thereby secure the prosthesis to the bone foundation guide.31. The apparatus of claim 30, further comprising a fastener, thefastener being configured to fit through the corresponding openings ofthe bone foundation guide and the tab, the fastener further beingconfigured for insertion into the first alveolar ridge while thefastener is disposed in the corresponding openings of the bonefoundation guide and the tab.
 32. The apparatus of claim 21, the bonefoundation guide further comprising a buccal wall, the buccal wall beingconfigured for positioning on a buccal side of the first alveolar ridgewhen the bone foundation guide is secured to the first alveolar ridge;wherein the first, second, and third surfaces are located on the buccalwall.
 33. The apparatus of claim 32, the bone foundation guide furtherincluding a lingual wall, the lingual wall being configured forpositioning on a lingual side of the first alveolar ridge when the bonefoundation guide is secured to the first alveolar ridge.
 34. Theapparatus of claim 21, further comprising a surgical guide, the surgicalguide being configured to fit on the bone foundation guide, the surgicalguide defining one or more apertures corresponding to implant attachmentsites in the first alveolar ridge.
 35. The apparatus of claim 34, thesurgical guide being configured to engage the second surface.
 36. Theapparatus of claim 21, the third surface being parallel with the firstsurface, the second surface being perpendicular to one or both of thefirst or second surfaces.
 37. A method, comprising: (a) securing a bonefoundation guide to a first alveolar ridge of a patient such that asurface of the bone foundation guide contacts a buccal side of the firstalveolar ridge; (b) securing a prosthesis to the bone foundation guide,the prosthesis defining a space, wherein bone of the first alveolarridge is disposed in the space; (c) visually observing at least aportion of the bone in the space via an opening defined by theprosthesis; (d) bringing an engagement surface of the prosthesis intocontact with one or more teeth of a second alveolar ridge of thepatient; (e) removing the prosthesis from the bone foundation guide; and(f) using the bone foundation guide as a guide to remove at least someof the bone from the first alveolar ridge.
 38. The method of claim 37,wherein the act of securing the prosthesis to the bone foundation guideis performed after the act of securing the bone foundation guide to thefirst alveolar ridge.
 39. The method of claim 37, further comprising:(a) securing a surgical guide to the bone foundation guide afterremoving the prosthesis and after removing at least some of the bone;and (b) forming an implant receiving opening in the first alveolar ridgevia an opening defined by the surgical guide.
 40. The method of claim37, wherein the bone foundation guide is secured to the first alveolarridge by at least one pin, wherein the prosthesis is secured to the bonefoundation guide by at least one pin.